FS Reports最新文献

{"title":"Surgical management of ovarian fibromas in young patients with Gorlin syndrome: a case series and review of the literature","authors":"Danielle T. Cipres M.D. ,&nbsp;Jessica Y. Shim M.D.","doi":"10.1016/j.xfre.2024.08.007","DOIUrl":"10.1016/j.xfre.2024.08.007","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the presentation and surgical management of ovarian fibromas among a case series of pediatric and adolescent patients with Gorlin syndrome.</div></div><div><h3>Design</h3><div>Retrospective case series.</div></div><div><h3>Setting</h3><div>Tertiary-care hospital.</div></div><div><h3>Patient(s)</h3><div>Patients aged 18 years and younger with a diagnosis of Gorlin syndrome who underwent surgical care of ovarian fibromas at a single tertiary children’s hospital from 1990 to 2022.</div></div><div><h3>Exposure</h3><div>Surgical management of ovarian fibromas.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Clinical characteristics, surgical treatment outcomes, ovarian conservation, surveillance imaging, and recurrence after surgical management of ovarian fibromas.</div></div><div><h3>Result(s)</h3><div>Four patients, aged between 5 and 18 years, underwent surgical resection of one or more ovarian fibromas. Dominant fibromas ranged in size from 4 to 9 cm, and most cases had multiple fibromas. Three patients underwent transverse laparotomies, and one patient had a laparoscopic approach. Unilateral oophorectomy was performed in three patients, two of whom presented with adnexal torsion. Among those with surveillance imaging, two patients with prior oophorectomy had a recurrence in the remaining contralateral ovary, one of whom underwent a second surgical procedure.</div></div><div><h3>Conclusion(s)</h3><div>Ovarian fibroma presentation and treatment varied widely among pediatric patients with Gorlin syndrome, and the presence of multiple and bilateral ovarian lesions raises important considerations regarding the optimal surgical approach and surveillance. Ovarian conservation should be prioritized in patients with Gorlin syndrome, because they are at risk of iatrogenic oophorectomy with their initial or repeat surgical management.</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 4","pages":"Pages 430-438"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A retrospective cohort study examining the outcomes of patients who present for fertility care and exceed a set body mass index threshold for treatment","authors":"Olutunmike Kuyoro M.D. ,&nbsp;Michal Mia Shalamov M.D. ,&nbsp;Cailey Brogan B.Sc. ,&nbsp;Randi Goldman M.D.","doi":"10.1016/j.xfre.2024.08.010","DOIUrl":"10.1016/j.xfre.2024.08.010","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the characteristics of patients who exceeded the body mass index (BMI) threshold for fertility treatment at their initial visit and identify those for whom treatment would be constrained.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Academic medical center.</div></div><div><h3>Patient(s)</h3><div>All new patients who presented for infertility treatment at an academic center between January 2020 and December 2022 and had BMI measured and recorded.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Likelihood of weight loss and treatment initiation for patients who exceed a set BMI threshold of 40 kg/m².</div></div><div><h3>Result(s)</h3><div>Of the 1,268 patients who had their BMI recorded at initial visit, 48% identified as non-Hispanic White, 15% as non-Hispanic Black, 13% as Asian, 11% as Hispanic, 0.2% as Native American, 4% as other; 9% were of unknown race/ethnicity. Overall, 6% of women exceeded the 40 kg/m² cutoff. Among Latino women, 7.5% exceeded the cutoff; among non-Hispanic Black women, 12% exceeded the cutoff. These percentages were greater than the percentage of non-Hispanic White women who exceeded the BMI cutoff (4.8%).</div></div><div><h3>Conclusion(s)</h3><div>Body mass index thresholds disproportionately affect the ability of ethnic minorities to use fertility treatment and could potentially be worsening barriers to care these population of patients already face.</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 4","pages":"Pages 417-421"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial removal of the zona pellucida at the pronuclear stage: an exploratory study to improve embryo fragmentation","authors":"Keitaro Yumoto B.Sc. ,&nbsp;Toko Shimura B.Sc. ,&nbsp;Minori Kawamoto M.Sc. ,&nbsp;Minako Sugishima B.Sc. ,&nbsp;Yasuyuki Mio M.D., Ph.D.","doi":"10.1016/j.xfre.2024.08.011","DOIUrl":"10.1016/j.xfre.2024.08.011","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate whether artificial removal of zona pellucida (ZP) at the pronuclear stage improves good-quality embryos and blastocyst development in patients with difficulty conceiving because of severe fragmentation in early-cleavage stage.</div></div><div><h3>Design</h3><div>Exploratory investigation.</div></div><div><h3>Setting</h3><div>Reproductive center.</div></div><div><h3>Patient(s)</h3><div>Thirty-four patients scheduled for assisted reproductive technology (ART) treatment in our clinic between February 2020 and January 2021 were selected to undergo ZP removal according to their ART-related medical history. In total, 173 two pronuclei zygotes were obtained, with 101 allocated to the ZP-free group and 72 to the ZP-intact group. All patients had zygotes allocated in both ZP-free and ZP-intact groups.</div></div><div><h3>Intervention(s)</h3><div>Oocytes that were confirmed to be normally fertilized were placed in sucrose-containing HEPES medium for approximately 5 minutes and cultured under one of the following two conditions: ZP-free, in which the ZP was completely removed from the ooplasm by laser irradiation and a medium-blowing method with a biopsy pipette; and ZP-intact. Subsequently, embryos were either freshly transferred on day 2 (ZP-intact group only, according to patients’ wishes), or day 5/6, or they were cryopreserved on day 5/6/7 for future embryo transfer cycles for both groups.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Rates of good-quality embryos, blastocyst development, morphologically good-quality blastocyst development, and cryopreservation.</div></div><div><h3>Result(s)</h3><div>In ZP-free embryos, the inter-blastomere adhesion was not disturbed and the fragmentation was significantly decreased that resulted into significant improvement in all measured parameters compared with the ZP-intact group.</div></div><div><h3>Conclusion(s)</h3><div>Artificial ZP removal at the pronuclear stage may prevent excessive fragmentation leading to good-quality blastocysts. Moreover, patients with recurrent ART failure may achieve successful pregnancies.</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 4","pages":"Pages 385-393"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do reproductive endocrinology and infertility fellowship websites reflect a commitment to diversity, equity, and inclusion?","authors":"Jasmine Eliwa M.D. ,&nbsp;Patricia J. Goedecke M.S. ,&nbsp;Jim Wan Ph.D. ,&nbsp;Rachel Weinerman M.D. ,&nbsp;Joseph Findley M.D. ,&nbsp;Rebecca Flyckt M.D.","doi":"10.1016/j.xfre.2024.08.005","DOIUrl":"10.1016/j.xfre.2024.08.005","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the frequency of diversity elements (DEs) in reproductive endocrinology and infertility (REI) fellowship websites and analyze these elements according to program characteristics.</div></div><div><h3>Design</h3><div>Forty-nine REI fellowship websites were assessed for 20 DEs that represent programmatic commitments to diversity, equity, and inclusion (DEI). Program websites were categorized by the number of discrete DEs featured: low (0–6); moderate (7–13); or high (14–20). Data were analyzed via R statistical software.</div></div><div><h3>Setting</h3><div>Not applicable.</div></div><div><h3>Patient(s)</h3><div>Not applicable.</div></div><div><h3>Exposure</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measure(s)</h3><div>The primary outcome was the level of DEs featured within REI fellowship websites. The secondary outcome was the association between DEs and program geographic region and accreditation status.</div></div><div><h3>Result(s)</h3><div>Program websites had a mean of 3 DEs. No program had a high number of DEs. Eighty-four percent of programs were low in DEs, with 16% exhibiting moderate DEs. Within the moderate group, most programs featured photographs of faculty (63%) and fellows (88%), commitment to DEI message (88%), diversity-specific language (88%), DEI webpage (88%), and DEI-related resources/opportunities (100%). In the low group, most programs presented photographs of faculty and fellows (71%). Programs did not feature active recruitment strategies (unconscious bias, holistic application review, DEI statistics, and implicit bias training). Diversity element category was not associated with program location. Programs with “initial accreditation” had the highest mean DEs.</div></div><div><h3>Conclusion(s)</h3><div>None of the REI fellowship websites demonstrated high levels of DEs. We speculate that by intentionally incorporating DEs into fellowship websites, programs can more effectively recruit underrepresented fellows and enhance the diversity of REI practitioners.</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 4","pages":"Pages 411-416"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fertility journey of a patient with McCune-Albright syndrome associated with bilateral ovarian involvement","authors":"Joanna J. Kim M.D. ,&nbsp;Stephanie Dufour M.D. ,&nbsp;Sara Awad M.B.B.S., M.H.P.E. ,&nbsp;Bryden Magee M.D.","doi":"10.1016/j.xfre.2024.08.006","DOIUrl":"10.1016/j.xfre.2024.08.006","url":null,"abstract":"<div><h3>Objective</h3><div>To report a patient with McCune-Albright syndrome (MAS) with bilateral ovarian involvement who had achieved a pregnancy through in vitro fertilization (IVF).</div></div><div><h3>Design</h3><div>Case report.</div></div><div><h3>Setting</h3><div>Academic fertility center.</div></div><div><h3>Patient(s)</h3><div>A 33-year-old female with McCune-Albright syndrome who presented with primary infertility because of ovulatory dysfunction secondary to excessive secretion of growth hormone in addition to autonomous estrogen secretion by her ovaries.</div></div><div><h3>Exposure</h3><div>In vitro fertilization and near-normalization of insulin-like growth factor-1 (IGF-1) using somatostatin analogue lanreotide.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Reproductive outcomes after medical treatment for MAS-associated anovulatory infertility involving bilateral MAS ovarian involvement and growth hormone excess.</div></div><div><h3>Result(s)</h3><div>Spontaneous ovulation was resumed in this patient using lanreotide which regulated IGF-1 levels after unsuccessful ovulation induction with letrozole. Despite documented ovulation, she failed to conceive and subsequently, underwent an IVF cycle using an antagonist cycle with recombinant follicular stimulating hormone and recombinant luteinizing hormone stimulation. A total of 13 oocytes were retrieved and three good quality blastocysts were cryopreserved. Two frozen embryo transfer cycles were completed and she achieved a pregnancy, which unfortunately ended in an incomplete miscarriage.</div></div><div><h3>Conclusion(s)</h3><div>Through IVF and near-normalization of IGF-1 using lanreotide, pregnancy was achieved in a patient with MAS who had achieved good ovarian stimulation despite a history of bilateral ovarian involvement and associated hyperfunctioning endocrinopathies.</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 4","pages":"Pages 453-457"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of elagolix in ovulation suppression during controlled ovarian stimulation: a retrospective cohort study","authors":"David Soliman M.Sc. ,&nbsp;Rita Naoom B.Sc. ,&nbsp;Mohamed Zaied B.Sc. ,&nbsp;Samuel Soliman M.D.","doi":"10.1016/j.xfre.2024.06.006","DOIUrl":"10.1016/j.xfre.2024.06.006","url":null,"abstract":"<div><h3>Objective</h3><div>To compare in vitro fertilization treatment outcomes for the oral gonadotropin-releasing hormone (GnRH) antagonist elagolix (E) to the conventionally used injectable GnRH antagonist ganirelix (G) for achieving pituitary gonadotropin suppression during a controlled ovarian stimulation (COS) cycle.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Private university-affiliated fertility center.</div></div><div><h3>Patient(s)</h3><div>One hundred and ninety-four infertility patients receiving either E or G for pituitary suppression during the COS cycle.</div></div><div><h3>Exposure</h3><div>Use of E for ovulation suppression during the COS cycle.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Biochemical pregnancy, sustained implantation, and cycle cancellation rates were the primary outcome measures. Secondary outcomes included miscarriage, fertilization, and blastulation rates.</div></div><div><h3>Result(s)</h3><div>The groups did not differ in their baseline demographic characteristics (age, body mass index, hormone profiles, total dosage of gonadotropins, number of oocytes retrieved, and number of embryos transferred). The overall cycle cancellation rates were 7.0% and 4.9% for e and G, respectively, and the difference was not statistically significant. For the frozen embryo transfers, the biochemical pregnancy, sustained implantation, and miscarriage rates for E were 74.5%, 51.0%, and 31.6%, respectively. For G, these were 55.9%, 39.8%, and 28.8%. Out of these outcomes, only the biochemical pregnancy rates were significantly different. For the fresh embryo transfers, biochemical pregnancy, sustained implantation, and miscarriage rates for E were 33.3%, 33.3%, and 0.0%, and for G, they were 37.5%, 25.0%, and 33.3%. None of the differences reached significance.</div></div><div><h3>Conclusion(s)</h3><div>The oral GnRH antagonist, E, may be as effective as the injected antagonist, G, regarding embryological and clinical outcomes and could offer a less invasive, more cost-effective, and “patient-friendly” approach to pituitary suppression for in vitro fertilization treatment.</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 4","pages":"Pages 356-362"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141700836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of utilization of advanced practice providers in reproductive endocrinology: a 2023 national survey","authors":"Tamara Tobias A.R.N.P., W.H.N.P.-B.C. ,&nbsp;Nicole Callahan M.S.N., F.N.P.-C. ,&nbsp;Laura Augustine D.N.P., F.N.P.-C. ,&nbsp;Barbara Tanaka M.S.N., W.H.N.P.-B.C.","doi":"10.1016/j.xfre.2024.09.002","DOIUrl":"10.1016/j.xfre.2024.09.002","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the current utilization of advanced practice providers (APPs) within the field of reproductive endocrinology and infertility.</div></div><div><h3>Design</h3><div>Cross-sectional.</div></div><div><h3>Setting</h3><div>Web-based.</div></div><div><h3>Patients</h3><div>A total of 201 APPs surveyed through the American Society of Reproductive Medicine APP Professional Group.</div></div><div><h3>Exposure</h3><div>Anonymized online survey.</div></div><div><h3>Main Outcome Measures</h3><div>Demographics, scope of practice and responsibilities, and training and onboarding.</div></div><div><h3>Results</h3><div>Respondents were primarily Family Nurse Practitioners (26.4%), Women’s Health Nurse Practitioners (33.3%), or Physician Associates (29.8%). Two-thirds (67.4%) reported that their scope of practice is limited by their employer or practice, 43.5% by state restrictions, and 25.2% by insurance. Survey respondents reported that 44.4% of their time at work is dedicated to performing procedures and scans and 30.6% to conducting consults and follow-ups. The most commonly reported duties were physical examinations (88.6%), intrauterine inseminations (86.6%), saline sonohysterograms (79.6%), endometrial biopsies (76.6%), ultrasounds (74.6%), and problem visits such as for pain, cysts, and bleeding (73.1%). Most survey respondents (61.7%) reported having autonomy in deciding protocols and treatment options for patients in their practice. Respondents described their onboarding training as including observation/on-the-job training (94.0%), independent reading of texts and journals (66.7%), American Society of Reproductive Medicine online courses (45.3%), formal orientation (34.8%), and practice-organized training programs (29.4%).</div></div><div><h3>Conclusions</h3><div>Advanced practice providers are highly trained members of the care team, but continue to be underused within the field of reproductive endocrinology and infertility. Improvements in educational resources and/or use of a formalized program to train APPs to their full scope of practice may help increase clinic efficiency and improve patient access to care.</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 4","pages":"Pages 363-368"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a mail-in delayed semen analysis protocol developed for home collection","authors":"Karen Racicot Ph.D. ,&nbsp;Denny Sakkas Ph.D. ,&nbsp;Brent C. Barrett Ph.D. ,&nbsp;Kenneth Chiang Ph.D. ,&nbsp;Charles Jenkins B.S.","doi":"10.1016/j.xfre.2024.10.005","DOIUrl":"10.1016/j.xfre.2024.10.005","url":null,"abstract":"<div><h3>Objective</h3><div>To validate a mail-in delayed semen analysis service using deidentified remnant samples from a US fertility clinic.</div></div><div><h3>Design</h3><div>Double-blinded prospective validation of screening/diagnostic test.</div></div><div><h3>Setting</h3><div>Fertility clinic and clinical reference laboratory.</div></div><div><h3>Patient(s)</h3><div>Deidentified remnant samples from patients attending fertility clinic for fertility assessment (study A, n = 68; study B, n = 232).</div></div><div><h3>Intervention(s)</h3><div>None.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Total motility, concentration, and morphology (Kruger, strict) measures were compared between split semen specimens that underwent comprehensive semen analysis at &lt;1 hour (referent) and 26 hours (experimental). The concordance between the paired measures was described using coefficient of variance and percent bias. Clinical concordance (CC) between 1- and 26-hour results for total motility, concentration, and morphology measures was also reported, using the fifth centile clinical reference ranges described in the World Health Organization manual (fifth edition).</div></div><div><h3>Result(s)</h3><div>In a controlled laboratory setting (study A), total motility, concentration, and morphology measures were highly consistent between the 1- and 26-hour analyses, with mean coefficients of variation (%CVs) of 9.0% for total motility, 4.0% for concentration, and 3.0% for morphology. There were also high CC rates: 94.2% for total motility; 100% for concentration; and 98.5% for morphology. In a real-world setting (study B), which included commercial shipment of specimens, the mean %CVs for total motility and concentration were 15% and 27%, respectively, which were more variable than those in study A yet still considerably less variable than that measured between laboratories using College of Anatomical Pathologist proficiency testing during the study period (motility %CV, 31%; concentration %CV, 37%). These comparisons also had high CC rates for total motility (86%) and concentration (93.1%).</div></div><div><h3>Conclusion(s)</h3><div>These results demonstrate the validation of a laboratory service that provides accurate, comprehensive semen analysis on specimens collected remotely and shipped overnight to a clinical diagnostic laboratory.</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 4","pages":"Pages 378-384"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in infertility workup costs across the United States","authors":"Naveena R. Daram M.D. ,&nbsp;Malika L. Day M.S. ,&nbsp;Rose A. Maxwell Ph.D. ,&nbsp;Meghan C. Ozcan M.D.","doi":"10.1016/j.xfre.2024.09.005","DOIUrl":"10.1016/j.xfre.2024.09.005","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate cost disparities of infertility diagnostic tests across the United States.</div></div><div><h3>Design</h3><div>Cross-sectional study analyzing costs for recommended infertility diagnostic tests, including hormone tests (follicle stimulating hormone, luteinizing hormone, estradiol, and progesterone), semen analysis, transvaginal ultrasound, and hysterosalpingogram. Data were sourced from consumer cost claims repositories for five most populous cities per state, categorized into four regions (Midwest, South, West, and Northeast) as per US Census Bureau classifications. Descriptive statistics and analysis of variance with Tukey’s post hoc tests evaluated cost variations across states and regions.</div></div><div><h3>Setting</h3><div>Not applicable.</div></div><div><h3>Patient(s)</h3><div>No individual subject data.</div></div><div><h3>Exposure</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Average costs for infertility diagnostic tests by states/regions, correlated with median household income, race, poverty, uninsured rate, and insurance mandates.</div></div><div><h3>Result(s)</h3><div>Alaska had highest total cost at $2,986, with Oregon the lowest at $835. Costs for all tests, except follicle stimulating hormone, varied significantly across states. Regional variations were noted, with luteinizing hormone, estradiol, transvaginal ultrasound, and hysterosalpingogram showing significant differences. Total workup costs varied by region, with Midwest having the highest average at $1,651, positively correlated with median household income, followed by Northeast, West, and South. States with insurance mandates for fertility coverage had lower uninsured rates. No correlation was found between state insurance mandates and costs.</div></div><div><h3>Conclusion(s)</h3><div>The study highlights significant regional cost disparities in infertility care, emphasizing complexities of access and affordability in the United States. Further research is needed to assess the out-of-pocket financial burden on patients and identify strategies to reduce these costs.</div></div>","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 4","pages":"Pages 422-429"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elagolix for ovulation suppression in in vitro fertilization: Is it time to switch from the painful costly injectables?","authors":"Zaher Merhi M.D., H.C.L.D.","doi":"10.1016/j.xfre.2024.11.001","DOIUrl":"10.1016/j.xfre.2024.11.001","url":null,"abstract":"","PeriodicalId":34409,"journal":{"name":"FS Reports","volume":"5 4","pages":"Pages 350-351"},"PeriodicalIF":0.0,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}